Abstract:Neurocognitive outcomes in HIV are strongly influenced by very early systemic virological and immunological events. Patients with high plasma levels of HIV RNA and low CD4 counts early after infection should be aggressively treated to prevent immunological decline and NP deterioration.
“…Within 5 years of estimated seroconversion, approximately 10% of those patients whose study baseline CD4 þ cell counts were greater than 400 cells/ml had developed HIV-related neurocognitive impairment. Conversely, 40% of those patients whose CD4 þ cell counts were less than 400 cells/ml at study baseline became neurocognitively impaired over the same time period [46]. Plasma viral loads greater than 30 000 copies/ml also independently predicted more rapid neurocognitive decline.…”
Section: Early Hiv Infection Of the Brainmentioning
confidence: 97%
“…Predictors of clinical neurocognitive disease progression in early HIV disease have been described in one longitudinal study from the pre-HAART era of 76 patients who seroconverted a median of 11 months (range, 1 month-4 years) prior to study entry [46]. Within 5 years of estimated seroconversion, approximately 10% of those patients whose study baseline CD4 þ cell counts were greater than 400 cells/ml had developed HIV-related neurocognitive impairment.…”
Section: Early Hiv Infection Of the Brainmentioning
The prescription of HAART in well, HIV-infected patients with high CD4+ cell counts may afford enhanced control of CNS HIV infection as a result of the benefits of HAART upon peripheral immune function. In turn, this may result in superior or preserved neurocognitive performance in comparison to the current practice of commencing HAART when CD4+ cells reach 350 cells/microl or lower. This hypothesis will be tested in an upcoming randomized clinical trial.
“…Within 5 years of estimated seroconversion, approximately 10% of those patients whose study baseline CD4 þ cell counts were greater than 400 cells/ml had developed HIV-related neurocognitive impairment. Conversely, 40% of those patients whose CD4 þ cell counts were less than 400 cells/ml at study baseline became neurocognitively impaired over the same time period [46]. Plasma viral loads greater than 30 000 copies/ml also independently predicted more rapid neurocognitive decline.…”
Section: Early Hiv Infection Of the Brainmentioning
confidence: 97%
“…Predictors of clinical neurocognitive disease progression in early HIV disease have been described in one longitudinal study from the pre-HAART era of 76 patients who seroconverted a median of 11 months (range, 1 month-4 years) prior to study entry [46]. Within 5 years of estimated seroconversion, approximately 10% of those patients whose study baseline CD4 þ cell counts were greater than 400 cells/ml had developed HIV-related neurocognitive impairment.…”
Section: Early Hiv Infection Of the Brainmentioning
The prescription of HAART in well, HIV-infected patients with high CD4+ cell counts may afford enhanced control of CNS HIV infection as a result of the benefits of HAART upon peripheral immune function. In turn, this may result in superior or preserved neurocognitive performance in comparison to the current practice of commencing HAART when CD4+ cells reach 350 cells/microl or lower. This hypothesis will be tested in an upcoming randomized clinical trial.
“…In general, higher CD4 cell counts, lower CD8 cell counts, and higher CD4:CD8 ratios have been associated with better neurobehavioral functioning [16]. However, contradictory data for adults [17] and children [18] have been presented.…”
Section: H I V / a I D S M A J O R A R T I C L Ementioning
“…HIV patients perform poorly on measures of complex attention, information processing speed and verbal memory, mental flexibility, motor speed, and verbal fluency [31][32][33][34][35][36][37][38]. This profile is typical of a "subcortical pattern" of brain injury [39] and is consistent with evidence of white matter and basal ganglia involvement found in neuropathologic studies.…”
Section: The Impact Of Hiv Monoinfection On Neuropsychological Outcomementioning
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